Bootcamp targets gap in radiation oncologist training

by Adela Talbot

Adam Gladwish, in his third year of a radiation oncology residency at the University of Toronto’s medical school, and Kara Schnarr, in her third year of residency at McMaster University’s medical school, joined 28 other residents across the country to attend last week’s Anatomy & Radiology Contouring Bootcamp for Radiation Oncology Residents, an intensive workshop environment to learn anatomy and contouring skills from London Health Sciences Centre doctors and Schulich School of Medicine & Dentistry professors. Credit: Adela Talbot, Western News

For the patient with laryngeal cancer – a cancer of the voice box – radiation therapy can be a lifeline. Alternately, it could be the thing that takes the patient's voice, before the disease takes their life.

This is precisely why radiation oncologists need training when it comes to contouring, a practice that outlines areas doctors must target to treat cancer, as well as healthy areas they need to avoid exposing to high doses of radiation.

Enter a recent course, hosted by members of the Western and London medical communities.

The Anatomy & Radiology Contouring Bootcamp for Radiation Oncology Residents brought together last week 30 residents from medical schools across the country, providing them with an intensive workshop environment to learn anatomy and contouring skills from London Health Sciences Centre (LHSC) doctors and Schulich School of Medicine & Dentistry professors.

"Radiation oncology has changed so much over the past 10 years that the teaching programs have not been able to keep up," said Western Oncology professor Dr. David Palma, a radiation oncologist at LHSC's London Regional Cancer Program.

Palma taught part of the course, and was on the committee that planned the bootcamp. Over the three days, residents worked with imaging scans as well as cadavers to master their skills.

"It used to be designed radiation; we used plain X-rays to design radiation and we'd put squares on X-rays to decide where to treat," Palma said.

However, those days are gone. Today's detailed high-resolution imaging with magnetic resonance imaging (MRI) and computed tomography (CT) scans offer a more detailed look at tumours and healthy tissues.

"Now, with our current ways of giving radiation, we can sculpt our radiation around all types of tumours and all types of normal tissues we want to avoid," Palma continued. "Tumours can be very tricky; they can have almost these tentacles, where they follow different nerves all around the body and it's very important our residents learn to follow where those tumours go, so they can treat them."

A survey across the country revealed radiation oncology residents would jump at the opportunity to take a course such as this. The contouring bootcamp was piloted for the past two years in London; this year was the first time it was offered to residents across the country. With 50 applicants this year, the course was capped at 30 to keep the group small, giving preference to upper-year residents who are closer to taking their exams, Palma explained.

"In radiation oncology, we spend a lot of time trying to figure out what's normal anatomy and what's abnormal anatomy. For the most part, we don't get formalized teaching in that; so it's a lot of learning as you go," said Julianna Caon, a fifth-year resident who attended the bootcamp from the University of British Columbia.

"This was never an area where we felt very comfortable, so when given the opportunity to take this (course), all of the residents in our department wanted to go. The training I got in medical school is not enough," she continued.

"A lot of these things are so intricate, so detailed it's not just easy to learn on your own, or have a natural aptitude for, so the specific training gives you that specific knowledge."

Jonathan Klein, in his fourth year of residency at the University of Toronto, echoed Caon.

"You need to know what's normal and what's abnormal (in anatomy) to give the patient the best chance of cure," Klein said. "If you don't know where the tumour is, the danger is you won't treat all the cancer. If you don't know where it is (and you target healthy tissue), you're going to give the patient undesirable side effects."

Palma said the plan is to continue running the bootcamp, giving other residents the chance to work on their anatomy and contouring skills.

Related Stories

A University of Colorado Cancer Center study recently published in the journal Physics in Medicine and Biology shows that endorectal balloons commonly used during precise radiation treatment for prostate cancer can deform ...

(HealthDay)—Some women with early breast cancer might benefit from a "one-and-done" treatment, in which they receive a single dose of targeted radiation therapy during the surgery that removes their tumor.

(Medical Xpress)—The genetic make-up of a patient's tumour could be used to personalise their treatment, and help to decide whether they would benefit from receiving additional drugs as part of their radiotherapy programme, ...

After five years of follow-up, a majority of asymptomatic, benign thyroid nodules exhibited no significant change in size, or actually decreased in size, and diagnoses of thyroid cancer were rare, according to a study in ...

Tumor recurrence following a period of remission is the main cause of death in cancer. The ability of cancer cells to remain dormant during and following therapy, only to be reactivated at a later time, frequently ...

Extra virgin olive oil (EVOO), long-known for its heart health benefits, has now been identified for its rapid destruction of cancer cells. While scientists have proven that the oleocanthal compound found ...

A magnetic resonance spectroscopy (MRS) technique that monitors biochemical changes in tissue could improve the management of women at risk of breast cancer, according to a new study published online in the ...

Despite sharp increases in spending on cancer treatment, cancer mortality rates in the United States have decreased only modestly since 1970, Samir Soneji, PhD of Dartmouth's Norris Cotton Cancer Center and The Dartmouth ...

User comments

Please sign in to add a comment.
Registration is free, and takes less than a minute.
Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.